What Does It Mean If My Biopsy Report Also Mentions Atrophy Adenosis Or Atypical Adenomatous Hyperplasia
All of these are terms for things the pathologist might see under the microscope that are benign , but that sometimes can look like cancer.
Atrophy is a term used to describe shrinkage of prostate tissue . When it affects the entire prostate gland it is called diffuse atrophy. This is most often caused by hormones or radiation therapy to the prostate. When atrophy only affects certain areas of the prostate, it is called focal atrophy. Focal atrophy can sometimes look like prostate cancer under the microscope.
Atypical adenomatous hyperplasia is another benign condition that can sometimes be seen on a prostate biopsy.
Finding any of these is not important if prostate cancer is also present.
Husbands Prostate Biopsy Results
My husband went to a local centre who were asking men to come and have a blood test for Prostate Cancer.He then received his results and was informed that it was showing a high result and to check with the GP.He referred my husband to a hospital consultant who sent him for a MRI.He wedas phoned up after 11 days to say that there was an abnormality shown up and he needed to come in for a biopsy,which was 2 days later.That was 4 weeks ago and we haven’t heard anything about the results.He was sent a follow up appointment for the 18th July,which will be nearly 6 weeks after the biopsy.Is this normal?Don’t know if to feel worried about the length of time this appointment will have taken?
Prostate Cancer Risk Groups
In addition to stage, doctors may use other prognostic factors to help plan the best treatment and predict how successful treatment will be. Examples of these include the National Comprehensive Cancer Network risk group categories and the Cancer of the Prostate Risk Assessment risk score from University of California, San Francisco.
Information about the cancers stage and other prognostic factors will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.
What To Think About
- If the test results show cancer, other tests may be needed to see the spread of the cancer. These tests may include a blood test , bone scan, lymph node biopsy, or CT scan.
What Does A Digital Rectal Exam Do
In a digital rectal exam , the doctor inserts a gloved finger into your rectum to feel for irregularities of the prostate. Its a common part of a mans routine physical examination.
Your doctor might perform a DRE alone or with a PSA test for routine screening. Its a quick and simple test. Although a DRE can signal a problem, such as an enlarged prostate, it cannot determine if its due to prostate cancer.
Prostate cancer is diagnosed 15 to 25 percent of the time when abnormal findings on a DRE lead to biopsy.
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Lymph Node Biopsy As A Separate Procedure
A lymph node biopsy is rarely done as a separate procedure. Its sometimes used when a radical prostatectomy isnt planned , but when its still important to know if the lymph nodes contain cancer.
Most often, this is done as a needle biopsy. To do this, the doctor uses an image to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.
Sections Of Your Report
Although pathology reports are written by physicians for physicians, you may be able to decipher some of the medical jargon provided by the report. The structure and information provided in your pathology report may vary, but the following sections are usually included.
Demographics: This section includes the patients name and date of procedure. You should check that this information is correct to ensure that you have the correct pathology report.
Specimen: The specimen section describes the origin of the tissue sample.
Clinical History: The clinical history section provides a brief description of the patients medical history relevant to the tissue sample that the pathologist is examining.
Clinical Diagnosis : The clinical diagnosis describes what the doctors are expecting before the pathologic diagnosis.
Procedure: The procedure describes how the tissue sample was removed.
Gross Description : The gross description includes the pathologists observations of the tissue sample using the naked eye. It may include size, weight, color or other distinguishing features of the tissue sample. If there is more than one sample, this section may designate a letter or number system to distinguish each sample.
- Grade 1 or well-differentiated: Cells appear normal and are not growing rapidly.
- Grade 2 or moderately-differentiated: Cells appear slightly different than normal.
- Grade 3 or poorly differentiated: Cells appear abnormal and tend to grow and spread more aggressively.
Why Is There So Much Blood After A Prostate Biopsy
During an ordinary prostate biopsy, they will usually take only 6-8 pieces of your prostate from different parts of it. In some cases, is quite possible for the urologist to take 10-14 pieces from your prostate. This will cause the rupture of more blood vessels, leading to increased amount of blood in the semen.
How Long Does It Take To Recover From A Prostate Biopsy
A patient may take about four to six weeks or even more recover after a prostate biopsy. The recovery process after biopsy usually depends on the patient’s health and age. Doctors may recommend only light activities for 24-48 hours after a prostate biopsy. The doctor prescribes painkillers, vitamins, and antibiotics for a few days to speed up the healing process.
After the biopsy, it is normal to experience the following sensations or symptoms:
- Burning urination: It may start within 24 hours after the biopsy and may continue until three to seven days. This burning sensation is a side effect of the procedure and usually considered normal.
- Frequent urination: It may gradually improve over the first 24-36 hours.
- Blood in the urine: It is considered normal to have slightly red-tinged urine or urine that resembles the color of a rose or red wine. This may last from 12 hours to 3 weeks after the biopsy.
- Blood in stool: A patient may notice red stains on the toilet tissue or see some bloody streaks in the stool. This may last for up to five days.
- Blood in the semen: This may persist for up to six weeks after the biopsy.
- Tiredness: A patient may feel tired for a month or two. It usually takes 30-45 days to regain full normal strength after the procedure hence, sufficient rest is usually advised by the doctor.
Post-biopsy restrictions and instructions:
How Should You Prepare For A Prostate Ultrasound And Biopsy
Preparation for a prostate ultrasound and biopsy is simple. You shouldnt take any blood-thinning medications such as warfarin , clopidogrel , aspirin or ibuprofen before a prostate biopsy because blood thinner increase the risk of bleeding. If you are already taking blood thinners, your doctor will discuss with you how many days prior to the biopsy they should be held.
Most healthcare providers dont ask you to follow any type of special diet before a biopsy. However, they suggest eating lightly before the procedure and drinking only clear liquids. Check with your providers office to see if you need to do anything additional to prepare for the test.
What Does It Mean To Have A Gleason Score Of 6 7 8 Or 9
Because grades 1 and 2 are not often used for biopsies, the lowest Gleason score of a cancer found on a prostate biopsy is 6. These cancers may be called well differentiated or low-grade and are likely to be less aggressive that is, they tend to grow and spread slowly.
Cancers with Gleason scores of 8 to 10 may be called poorly differentiated or high-grade. These cancers are likely to grow and spread more quickly, although a cancer with a Gleason score of 9-10 is twice as likely to grow and spread quickly as a cancer with a Gleason score of 8.
Cancers with a Gleason score of 7 can either be Gleason score 3+4=7 or Gleason score 4+3=7:
- Gleason score 3+4=7 tumors still have a good prognosis , although not as good as a Gleason score 6 tumor.
- A Gleason score 4+3=7 tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor.
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How Often Does A Negative Prostate Biopsy Occur
Considering that most studies of modern extended biopsies identify cancer in 40%-50% of initial biopsies, there are reasonably more than one half million new cases each year of men with negative prostate biopsies.
Biopsy results does how long you have to wait mean something? I can only speak for breast cancer biopsy but yes it took nearly 2 weeks to come back and this is because the pathology testing is only part of the process. The results then go to a multidisciplinary team for discussion and if cancerous, a treatment plan drawn up.
What Are Grade Groups
Grade Groups are a new way to grade prostate cancer to address some of the issues with the Gleason grading system.
As noted above, currently in practice the lowest Gleason score that is given is a 6, despite the Gleason grades ranging in theory from 2 to 10. This understandably leads some patients to think that their cancer on biopsy is in the middle of the grade scale. This can compound their worry about their diagnosis and make them more likely to feel that they need to be treated right away.
Another problem with the Gleason grading system is that the Gleason scores are often divided into only 3 groups . This is not accurate, since Gleason score 7 is made up of two grades , with the latter having a much worse prognosis. Similarly, Gleason scores of 9 or 10 have a worse prognosis than Gleason score 8.
To account for these differences, the Grade Groups range from 1 to 5 :
- Grade Group 1 = Gleason 6
- Grade Group 2 = Gleason 3+4=7
- Grade Group 3 = Gleason 4+3=7
- Grade Group 4 = Gleason 8
- Grade Group 5 = Gleason 9-10
Although eventually the Grade Group system may replace the Gleason system, the two systems are currently reported side-by-side.
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How Important Is The Gleason Score
The Gleason score is very important in predicting the behavior of a prostate cancer and determining the best treatment options. Still, other factors are also important, such as:
- The blood PSA level
- How much of each core is made up of cancer
- The number of cores that contain cancer
- Whether cancer was found in both sides of the prostate
- Whether the cancer has spread outside the prostate
Further Testing For Advanced Cancer
If there’s a significant chance the cancer has spread from your prostate to other parts of the body, further tests may be recommended.
- an MRI scan, CT scan or PET scan these scans build a detailed picture of the inside of your body
- an isotope bone scan, which can tell if the cancer has spread to your bones a small amount of radiation dye is injected into the vein and then collects in parts of the bone where there are any abnormalities
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What Happens After A Prostate Ultrasound And Biopsy
When the procedure is finished, you may resume your normal meals and daily activities, unless otherwise instructed. Some urologists may prescribe an antibiotic after the biopsy to prevent any infections, but given antibiotics only prior to the biopsy. Some men may have soreness for a few days after the procedure, which is normal. Your provider will contact you when your results are available
How Are Tissue Samples Obtained
Most cancer patients will undergo a biopsy or other procedure to remove a sample of tissue for examination by a pathologist in order to diagnose their disease. There are a variety of methods used to obtain samples, including a typical biopsy, fine needle aspiration, or a biopsy with the use of an endoscope. The method used to gain a tissue sample depends on the type of mass and location in the body. Doctors are increasingly using “liquid” biopsies to evaluate cancer which are easily collected from the blood and are non-invasive. Liquid biopsies are replacing the need to collect tissue in many situations.
A typical biopsy involves the surgical removal of a mass of abnormal cells. Fine needle aspiration involves guiding a thin needle into the cancer and gently sucking out cells for microscopic evaluation. An endoscope is a lighted tube that can be guided into the body through an orifice, such as the mouth or anus, and is used to perform a biopsy. It allows the physician to see the cells in question and then scrape the abnormal cells in order to get a sample. For example, throat cells may be sampled in this way.
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How Long Does It Take For A Cancer Biopsy To Come Back
A malignant tumor is cancerous and can possibly spread to other parts of the body. A result can often be given within 2 to 3 days after the biopsy. A result that requires a more complicated analysis can take 7 to 10 days. Ask your doctor how you will receive the biopsy results and who will explain them to you.
Reasons For Delays In Getting Your Biopsy And Cytology Test Results
The uncertainty you feel while waiting for biopsy and cytology test results can cause a lot of stress and anxiety. Not knowing when the results will be ready and not understanding why testing sometimes takes longer than expected can cause extra concern.
Routine biopsy and cytology results may be ready as soon as 1or 2 days after the sample gets to the lab. But there are many reasons some take much longer to complete.
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How To Get The Best Results
Most men do not find prostate biopsy excessively painful or uncomfortable, and the complications are usually not seriousbut can be. Certain steps taken before, during, and after the procedure can improve the outcome:
Take antibiotics. Taking preventive antibioticsbefore and after the procedurecuts the risk of infection substantially. Most infections are not dangerous but could become so if they get out of control. The overall chance of being hospitalized with an infection after prostate biopsy is 1% to 3%.
Review medications. Before the biopsy, your doctor may advise you to stop taking daily low-dose aspirin or an anticoagulant such as warfarin , dabigatran , edoxaban , rivaroxaban , or apixaban . These drugs reduce the blood’s ability to clot. Your doctor will weigh the chance of bleeding against the need for anticoagulants to prevent heart problems or stroke.
Expect anesthesia. Get local anesthesia for the biopsy. This means an injection of a numbing drug into the prostate gland to reduce pain during the biopsy.
Are There Any Problems To Expect After A Prostate Ultrasound And Biopsy
In some cases, men can develop a urinary tract infection or an infection in the prostate. These infections are rare and easy to treat with prescribed antibiotics.
Blood in the urine and/or stool is common for three to five days after the biopsy. It is also common to have blood in your semen for up to two to three months after the biopsy. This is not harmful to you or your partner and will eventually go away on its own. You should avoid heavy lifting for two to three days to help avoid bleeding issues.
Some men may also have trouble urinating after the procedure. Most problems are minor and go away on their own after a few days. If you arent able to urinate at all, call your healthcare provider or go to the emergency room. Make sure that you tell them that you just had the ultrasound and biopsy.
- A fever of 100 degrees F or higher.
- Shaking or chills.
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What Are Some Common Uses Of The Procedure
A prostate biopsy is currently the only way to definitively diagnose prostate cancer. It also helps differentiate cancer from benign prostatic hyperplasia or nodular enlargement of the prostate, a very common condition in middle-aged and older men that requires a different treatment approach than that of cancer.
A prostate biopsy may be ordered if the physician detects a nodule or other abnormality on the prostate during a digital rectal examination , a common prostate cancer screening test.
A biopsy also may be ordered when a blood test reveals elevated levels of prostate-specific antigen. While there are several reasons for an elevated PSA level, higher PSA levels are sometimes associated with cancer. PSA trends over time may trigger your physician to order a biopsy.
MRI-guided prostate biopsy may be used in patients who have a rising PSA level yet a negative ultrasound-guided biopsy. It also may be used in situations where a diagnostic prostate MRI performed due to rising PSA demonstrates a very small abnormality that may not be easily targeted by ultrasound. MRI is also useful in patients who have previously undergone a biopsy and want to improve the sensitivity of the procedure and the precision of the biopsy.
A biopsy not only detects cancer it also provides information on the aggressiveness of the cancer and helps to guide treatment decisions.